PARENTS AND PHYSICIANS VIEWS ON ANTIBIOTICS

Objective. To describe parents' opinions and concerns about antibiotic s and to contrast these opinions with those of pediatricians. Design. Parents were surveyed using an interviewer-administered questionnaire and pediatricians were mailed a self-administered questionnaire. Resul ts. Parents from two private practices (N = 300) were largely white (8 4%) and had completed college (81%). The parents from a community heal th center (N = 100) were mostly black (80%) and had not completed coll ege (91%). Twenty-nine percent of parents were worried that their chil dren were receiving too many antibiotics. Eighty-five percent believed there were problems with receiving too many antibiotics, with 55% men tioning resistance or immunity as concerns. Eighteen percent of parent s had given their child an antibiotic at home before consulting a phys ician. Parents believed that antibiotics were always or sometimes requ ired for ear infections (93%), throat infections (83%), colds (32%), c ough (58%), and fever (58%). Fourteen percent of parents believed that their child had required an antibiotic when the doctor did not prescr ibe one, with clinic parents significantly more likely to report this issue (22%) than private practice parents (12%). Nine percent believed that their doctor had prescribed an antibiotic unnecessarily (private practice = 12%, community health center = 3%). Parents from the priva te practices were also more likely to report requesting a specific ant ibiotic (34%) in comparison with 19% of clinic parents. Sixty-one perc ent of the physician surveys were returned after two mailings and a fo llow-up phone call. The pediatricians had been in practice for a media n of 12 years, seeing a median of 110 patients per week. Fifty-eight p ercent of pediatricians reported that some, many, or most of the paren ts in their practices were worried that their children were receiving too many antibiotics. Seventy-one percent indicated that four or more times during the previous month, a parent had requested an antibiotic when the physician believed it was unnecessary, and 35% said that at l east occasionally they went along with these requests. Sixty-one perce nt reported that parents requested a different antibiotic from the one they were going to prescribe at least four times in the previous mont h, and 30% of pediatricians said that they agreed to parents' requests often or most of the time. Conclusions. Both the parent and the physi cian surveys suggest that parents are concerned about the overuse of a ntibiotics, but often request them when their physicians believe they are unnecessary. Parents often administer antibiotics without physicia n knowledge, and many parents have misconceptions about which illnesse s warrant antibiotic therapy. Understanding parents' concerns and beli efs about antibiotics and the range of physician practice styles with respect to antibiotics may direct the development of intervention stra tegies to reduce the inappropriate use of oral antibiotics.